February 16, 2010

How to Deal with Trauma Nightmares

One of the most distressing symptoms of trauma can be the nightmares it evokes. They attack when you are peacefully asleep and off guard. Not being able to get a good night's rest can seriously compromise your mental health and make other trauma symptoms worse. If they persist you may even develop a fear of going to sleep.

Because they are so terrifying most people try to damp them down and ignore them. Actually, what needs to happen is the opposite. These memories need to come forward and be expressed and experienced in order for you to be free of them. Stuffing them down only causes you to carry the pain the rest of your life. It may also provoke you to develop numbing mechanisms to distract you from the pain you are ignoring; eating, drinking, taking prescription medications, shopping or spending, gambling, traveling, smoking, etc.

How do you know they are trauma dreams?

Most trauma dreams repeat themselves over and over. They are usually memories of what actually happened to you. Some may take on a more symbolic form, especially if the original trauma happened a long time ago. But most are reptitive in nature. And most trauma dreams replay the part of the trauma which hurt you the most, which you have the most trouble dealing with, or which raises the biggest question for you. Regular nightmares that are not related to trauma tend to be unique each time. Naturally, there are exceptions to every rule, but this is how it generally goes.

Trauma nightmares can also reflect our fears as well as what actually happened. You may begin to dream that members of your family get hurt. You may begin to dream that you get hurt in a way other than the actual trauma. This is your brain expressing what it now fears, rather than what actually happened. These dreams provide you with important information about what you fear.

Trauma nightmares are good.

What??? How could something so terrifying be good? Nightmares let you know your brain is working on the problem. Our brains are marvelous things. When we get hurt they act like big computers, replaying the event over and over, trying to make sense of it. Our brains treat traumas as problems to be solved. In replaying the event over and over your brain is trying to figure out how to avoid getting hurt that way again. It is trying to make sense of what happened to you. It can find resolution by pulling those painful memories out, experiencing them, and making sense of them. Your brain is also trying to accept what happened to you. To get used to the idea that something horrible happened. To get used to the feelings of powerlessness.

Instead of ignoring them, drowning them out with sedatives or alcohol or staying up all night to avoid sleep, treat them as vital information. The brain remembers that you got hurt once and is trying to give you information about where, how and when that happened so you can avoid it in the future. It is also trying to give you information about how the trauma affected you. Dreams about family members getting hurt, or about you getting hurt in a different way let you know what fears you have developed as a result of the trauma. Instead of viewing the brain as the enemy and trying to fight against it, treat it as an ally. It is trying to tell you something.

To work with your brain instead of against it, find ways to help it express the memories. First, you have to hang onto the dreams long enough to work with them. Keeping a Dream Journal by your bed allows you to record the dreams you were having just before you woke up. Jotting dreams down before they fade into the ether of daily life will preserve them for you to review at a later time. You can also look back at the journal for patterns, themes or symbols in your dreams.

Second, find a medium which is comfortable for you and see if you can help the brain get its message to you instead of blocking it. Paint the nightmares. Draw the nightmares. Journal about the nightmares. Tell a therapist about the nightmares. Sing the nightmares. Tell a trusted friend about the nightmares. Dance the nightmares. Using the format of self expression most comfortable to you, pull the nightmares out and make them real. Then ask yourself, "What message is the brain trying to send to me? What does it want me to know from this?"

Third, sit with the the nightmare and feel the feelings which come up. In order to do this you may need to set a time limit and prepare a special place in your home where you feel especially safe. By limiting the emotions to, say, 15 minutes you know there will be an end, it will not go on forever. Many people like to set an egg timer so they hear the "ding" when the time is up. This provides an audible cue to bring them back to the present. Creating a safe place is unique to each individual. Some people like to be in tight, contained spaces when feeling afraid, so they build a cozy corner of their closet in which to cuddle. They may put a favorite blanket, comforter, pillow or stuffed animal there. Some people feel absolutely terror when confined to small spaces. "Safe" to them may be to go outside and stand in the sunshine and fresh air, walk on the beach or sit on their patio. Only you can decide what feels safe to you.

Allowing your brain to bring forth painful information to be remembered and experienced has a purgative effect on your trauma symptoms. It gets the pain outside of you so you don't have to carry it around for the rest of your life. However, it is absolutely crucial that you move at your own pace and don't let others tell you when it's time to "get over it". It's your pain. Only you know how much it hurts and how much of it you can take at a time. If it starts to overwhelm you; if you start to feel like you are losing it, if you start to feel suicidal or homicidal, if you start self-mutilating, if it starts to threaten your employment or supportive relationships it is absolutely imperative that you seek outside help from a trained professional. Be specific when you call about the type of trauma you have and ask about their experience in dealing with trauma issues. They should have specialized knowledge and experience in treating trauma.

(If you ask who they've learned the most from or whose methods they've studied you should hear at least one of these names; Babette Rothschild, Bessell van der Kolk, Peter Levine, Judith Herman. I'm sure there are more and I'll add them as I think of them. Fellow therapists? Anyone I left out?)